Lipoprotein(a) Testing Remains Uncommon In The United States

Researchers from University of California San Diego School of Medicine person recovered that testing for lipoprotein(a) - a familial consequence facet for bosom illness - remains uncommon successful nan United States, contempt humble increases complete nan past decade. The findings were published connected Sept. 26, 2025 successful nan Journal of nan American College of Cardiology: Advances.

Lipoprotein(a) - aliases Lp(a) - is simply a type of cholesterin particle successful nan blood. Elevated levels are powerfully linked to a higher consequence of bosom attack, changeable and aortic valve disease. Roughly 20% of nan U.S. organization has elevated Lp(a), yet testing rates person historically been low.

In nan caller study, researchers analyzed records from Epic Cosmos, a nationalist database that includes complete 300 cardinal diligent records from wellness systems crossed each 50 states. This is nan first published study to measure this measurement of patients astatine this standard and nan first to usage Epic Cosmos successful nan University of California system.

They recovered that betwixt 2015 and 2024, conscionable 728,550 patients, representing only 0.2% of nan U.S. population, underwent Lp(a) testing. Testing accrued from astir 14,000 patients successful 2015 to much than 300,000 successful 2024, but wide rates stay acold beneath what experts urge for identifying individuals astatine risk.

As an early predictor of bosom disease, European countries are pushing toward cosmopolitan testing. The U.S. is acold down this goal.

By analyzing nationalist information from complete 300 cardinal patients, we've uncovered really overmuch activity remains to bring Lp(a) testing into regular care. These insights springiness america a roadmap for expanding entree and addressing gaps. We're seeing a increasing nickname among clinicians of nan value of Lp(a) testing, but nan debased wide testing rates and location imbalances item really overmuch further we request to go. Broader consciousness and entree to testing could make nan quality betwixt catching illness early and missing an opportunity to forestall bosom attacks and strokes, ensuring that each patients use from emerging therapies."

Mattheus Ramsis, M.D., lead writer and adjunct professor of medicine astatine UC San Diego School of Medicine

The study revealed notable differences among groups. Testing was astir communal among adults ages 50 to 65, and testing rates were astir adjacent betwixt men and women. However, stark group and taste differences were observed: little than 10% of those tested were Black, and only 7% identified arsenic Hispanic aliases Latino, contempt some groups being disproportionately affected by cardiovascular disease. Most testing occurred among achromatic patients.

Geographic differences were besides pronounced. California, Ohio and Texas accounted for nan largest stock of tests, together representing much than a 4th of nan nationalist total. Some states had almost nary uptake of Lp(a) testing, underscoring nan uneven dispersed of consciousness and objective believe crossed nan country.

The study besides recovered a displacement successful really tests are being conducted. In 2015, astir measurements utilized older "mass-based" assays, which measurement nan full weight of Lipoprotein(a) successful a humor sample. However, by 2024, two-thirds of tests were performed utilizing nan much meticulous molar assays, successful statement pinch evolving objective guidelines. Molar assays measurement nan existent number of Lp(a) particles successful a person's bloodstream to measure cardiovascular illness risk, alternatively than conscionable nan wide of particles.

Lp(a) is unsocial among cholesterin particles because levels are wished almost wholly by genetics and stay unchangeable passim life. Unlike low-density lipoprotein (LDL) cholesterol, Lp(a) does not respond to fare aliases manner changes, and nary wide disposable therapies presently beryllium to little it. However, respective treatments are now successful late-stage objective trials. Experts propose that broader take of testing could thief place high-risk patients who whitethorn use from these upcoming therapies.

Despite expanding awareness, testing remains rare. National guidelines presently urge astatine slightest 1 life Lp(a) trial for adults, particularly for those pinch a family history of premature cardiovascular disease. Still, pinch less than 1 successful 500 Americans receiving nan trial annually, nan UC San Diego squad says location is overmuch activity to do.

"The emergence successful testing is encouraging, but we are still acold from wherever we request to be," said study co-author Ehtisham Mahmud, M.D., professor of medicine and Edith and William Perlman Endowed Chair successful Cardiology, main of nan Division of Cardiovascular Medicine and executive head of nan Cardiovascular Institute astatine UC San Diego. "If we want to adjacent nan gaps successful cardiovascular consequence assessment, particularly successful underserved communities, we request broader education, clearer guidelines and accordant security sum for Lp(a) testing."

The researchers stress that their study is not conscionable astir testing rates but astir equity. Because cardiovascular illness remains nan starring origin of decease successful nan U.S., ensuring that each populations person entree to emerging diagnostic devices is critical.

Future investigation will research why immoderate populations and regions lag successful adopting Lp(a) testing. The UC San Diego squad besides hopes to study really testing patterns germinate arsenic caller Lp(a)-lowering therapies participate objective believe successful nan adjacent respective years.